infectious-diseases-clinical-care, science-brief
| March 1, 2021
Tocilizumab for Hospitalized Patients with COVID-19
Tocilizumab, an interleukin (IL-6) receptor antagonist, reduces the need for mechanical ventilation, progression to mechanical ventilation, and the combined endpoint of progression to mechanical ventilation or death in hospitalized patients with COVID-19, with no increase in significant adverse effects.
Tocilizumab should be used in moderately ill hospitalized patients (i.e., requiring supplemental oxygen via nasal prongs) and critically ill hospitalized patients (i.e., requiring oxygen via venturi mask, high-flow nasal cannula, non-invasive mechanical ventilation, invasive mechanical ventilation, or extra-corporeal membrane oxygenation (ECMO)) with suspected or confirmed COVID-19 who are on recommended doses of dexamethasone (or another dose-equivalent corticosteroid) and are within 14 days of hospital admission or within 14 days of a new COVID-19 diagnosis if acquired in a healthcare setting.
Moderately ill patients should have additional evidence of systemic inflammation, defined as a C-reactive protein (CRP) of 75 mg/L or higher, and have evidence of disease progression (i.e., increasing oxygen or ventilatory requirements) while on dexamethasone or another dose-equivalent corticosteroid for treatment of COVID-19.
